About endocrine diseases
Endocrine diseases are disorders of the endocrine system, a complex system of organs and glands that help to control vital functions in the human body through substances called hormones. This hormone imbalance can affect a person’s health in many ways, and some endocrine diseases are more common than others. Endocrine diseases include diabetes and more rare conditions such as acromegaly and Cushing’s disease.
Acromegaly is a rare but serious condition that is caused by too much growth hormone (GH). Growth hormone is produced by the pituitary gland, a tiny gland located at the base of the brain.
In most cases of acromegaly, the excessive production of growth hormone is due to a pituitary tumor, the majority of which are benign (not cancerous). The excess growth hormone leads to enlargement of hands, feet and facial features. It can also affect internal organs and cause a variety of potentially serious complications if left untreated.
Too much GH can impair glucose and lipid metabolism and can result in serious health consequences of acromegaly, such as diabetes, high blood pressure and increased risk of cardiovascular disease.
Treatment of acromegaly
Too much GH raises the level of insulin-like growth factor-1 (IGF-1), a hormone that also promotes growth. Managing acromegaly can lead to better control of GH and IGF-1 to help alleviate symptoms of the disease, help you feel better and possibly reduce the risk of more serious health issues associated with the disease.
The main goal of treatment is to lower the growth hormone and IGF-1 levels to normal. There are several ways to treat acromegaly, including:
- Surgery to remove the pituitary tumor. The goal of surgery is to remove the pituitary tumor and, consequently, control GH secretion.
- Medical therapy. Medical treatment for acromegaly can reduce GH secretion and IGF-1 production.
- Radiation therapy of the pituitary. Radiation of the pituitiary slowly reduces GH secretion and IGF-1 production. Patients might not receive the full effects of this therapy for many years. Radiation should not be used as the primary therapy except under extraordinary circumstances.
Frequently, adequate control of acromegaly calls for a multi-modality approach, resulting in a combination of treatments.
Questions to ask your doctor
If you have recently been diagnosed with acromegaly, be sure to speak with your doctor about questions you may have about your diagnosis:
- If left untreated, what is my risk of serious complications such as diabetes and heart disease?
- Do I need treatment right away?
- What are my treatment options?
- Am I a candidate for surgery?
- Do I need treatment right away?
- What are the advantages and disadvantages of each type of treatment?
- What is the likelihood that the treatment options you recommend will:
- Normalize my GH and IGF-1 levels?
- Control the tumor mass without harming normal pituitary function?
- Relieve the signs and symptoms?
- Improve my life expectancy?
- How quickly will I experience relief of my symptoms with each treatment?
- How is each treatment administered?
- How will each treatment affect my daily life?
- How will you be monitoring my condition (i.e., pituitary tumor size, GH levels, IGF-1 levels, symptoms)?
- Should I alter my diet?
About Cushing’s syndrome and Cushing’s disease
Cushing’s disease is a condition in which the pituitary gland releases too much Adrenocorticotropic hormone, or ACTH. It is caused by a tumor of the pituitary gland, located at the base of the brain. The excess ACTH travels to adrenal glands. The adrenal glands are then bombarded with signals to produce more and more cortisol. Too much ACTH means too much cortisol.
Having high levels of cortisol (known as hypercortisolism) in your body for too long can cause several signs and symptoms, including:
- A round (moon-shaped) and/or red face
- Purplish streaks across the skin
- Unusual buildup of fatty tissue between the shoulder blades (sometimes called “buffalo hump”)
- Unusual buildup of fatty tissue in the abdominal area with thin arms and legs
- Easy bruising
- Excess facial/body hair growth (called “hirsutism”) in women
Being correctly diagnosed with Cushing’s syndrome, followed by Cushing’s disease, is the first step toward regaining control of your health because an accurate diagnosis helps your doctor determine the best course of action. Cushing’s syndrome and Cushing’s disease may be challenging to diagnose because of several factors:
- Other more common conditions (e.g., depression and weight problems caused by improper diet and/or exercise) cause the same signs and symptoms.
- The signs and symptoms are not the same for all people.
- Long-term exposure to high levels of cortisol may result in disorders such as diabetes, high blood pressure and osteoporosis.
Through general awareness of the signs, symptoms and conditions associated with Cushing’s syndrome and Cushing’s disease, more people may be diagnosed and treated earlier.